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q° " • SAN JOAQUIN COUNT01 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> �;.. Telephone:(209) 468-3420 Fax.(209) 464-0138 Web:www.siaov.ora/ehd <br /> �IFOa� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: n c��rd Date: _a <br /> Address: �O r City: - 0 Zip Code: <br /> Owner/Operator: _ n ephone:_{b-,G� _ a AV <br /> Program Element: Program Re ord:, I s s Inspection Type: <br /> SB18O Posted ❑Yes rNo Permit Posted Yes :'. No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Ma-or violations pose a threat to public health and must be corrected immediately, Non-compliance may warrant closure o/the/ood racllit <br /> �N wo wn Demonstration of Knowledge nu, our cos Supervision our <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> ✓ Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use <br /> 6. Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> Time and Temperature Relationship Food Storage/Display/Service. <br /> Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 2. Food property labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment/.Utensils/Linens <br /> 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean <br /> Protection From Contamination 4. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. Equipment/utensils approved;installed;clean;good repair <br /> 13. Food tree from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> Food From Approved Source 38. Approved and sufficient ventilation and lighting <br /> ✓' 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 46. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. l..:compllance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility usealcl 46. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received Bylrltle: <br /> EH Specialist: \ Phone:2:4) q61P S.-? Page 1 Of. <br /> EHD 16-23 (1st pg) Mall-2 �+/�) FOOD PROGRAM OR <br />